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Lower Crossed Syndrome - ''S-Posture''

Cats and Dogs

October 04, 2007
By Greg Rose Titleist Performance Institute

Lower back pain is one of the most common complaints of all golfers. This is usually due to the high velocity rotary forces that are applied upon the lumbar spine during the golf swing. Even the best golfers in the world, with the best swing mechanics can develop lower back discomfort. So if you're one of those golfers who suffer from lower back pain, what can you do to get back to pain-free golf?

Remember this rule, "If it looks like a dog, smells like a dog, it's usually a dog." In other words, there could be a million things wrong with your back, but they're usually a couple of things that create the majority of lower back discomfort in golfers. These must be ruled out first before we start looking for a rare diagnosis. One of the most common causes of lower back pain in all golfers is the lower crossed syndrome or the "S-posture".

The Lower Crossed Syndrome / "S-Posture":

One of the most clinically relevant patterns of muscle dysfunction is a lower crossed syndrome. Simply stated, the lower crossed syndrome is a grouping of weak muscles combined with overactive or tight muscles, that create a predictable movement pattern in the lower back that can lead to injury. A physical therapist from the Czech Republic, named of the Vladamir Janda, was really the first person to document this type of muscle imbalance. Janda noticed that many people developed a distinct pattern of muscle imbalances due to prolonged static postures, such as sitting at a desk all day.

He noted that when a muscle is subjected to a short or contracted state for an extended period of time it causes a reflex inhibition or weakening of the muscles on the opposite side of the body, called reciprocal inhibition. For example, if you sit in a chair for eight hours a day, with time your hip flexors will become shortened or tight. Therefore, your brain will automatically start to shut down or inhibit your glute muscles (butt) which are on the opposite side. Now, since your glute muscles are not working properly your body will recruit synergistic muscles like the hamstrings and lower back muscles to assist the glutes in performing hip extension. In other words, you start to recruit muscles that were not intended to be used for specific actions such as walking.

The most common pattern of imbalance that Janda observed, he named the Lower Crossed Syndrome. It is basically the combination of tight hip flexors and a tight lower back, paired with weak abdominals and weak glutes. This combination leads to an excessive arching or rounding up your lower back (swayback), a flabby or protruding abdomen, and a flat butt due to weakness in the glutes. This is a very dangerous combination of muscle imbalances due to the excessive stress that it places on the structures of the lower back.

It is easy to spot a golfer who has a lower crossed syndrome by observing their set-up posture from down-the-line. If you look at their lower back it has an excessive swayback or curvature creating what we call, the "S-posture".

Some golfers actually put themselves into this position on purpose because they heard it was good to stick their butt out at set up. Unfortunately, if you arch your back to stick your butt out at set up, you are also putting your lower back in jeopardy of being injured.

You can actually stick your butt out at set up without arching your back if you just hinge from your hips and keep your spine in a neutral stable posture. Obviously, this requires good core strength and proper stabilization in the lumbar spine.

So if you have a lower crossed syndrome, the good news is this is very easy to eliminate. All you need to do is perform stretches to help lengthen your hip flexors and lower back muscles, and perform exercises that help develop strength in the abdominals and glute muscles. Once these muscle imbalances are corrected, work on developing strength in a stable neutral lower back posture. Above are a series of exercises that will guide you through the process of eliminating the lower crossed syndrome. Good luck!